Deep phenotyping of 34,128 patients hospitalised with COVID-19 and a comparison with 81,596 influenza patients in America, Europe and Asia: an international network study

Burn, Edward; You, Seng Chan; Sena, Anthony G.; Kostka, Kristin; Abedtash, Hamed; Abrahão, Maria Tereza Fernandes; Alberga, Amanda; Alghoul, Heba; Alser, Osaid; Alshammari, Thamir M; Aragón, María; Areia, Carlos; Banda, Juan M.; Cho, Jaehyeong; Culhane, Aedín; Davydov, Alexander; DeFalco, Frank; Duarte‐Salles, Talita; DuVall, Scott L.; Falconer, Thomas; Fernández-Bertolín, Sergio; Gao, Weihua; Golozar, Asieh; Hardin, Jill; Hripcsak, George; Huser, Vojtech; Jeon, Hokyun; Jing, Yonghua; Jung, Chi Young; Kaas‐Hansen, Benjamin Skov; Kaduk, Denys; Kent, Seamus; Kim, Yeesuk; Kolovos, Spyros; Lane, Jennifer C E; Lee, Hyejin; Lynch, Kristine E.; Makadia, Rupa; Matheny, Michael E.; Mehta, Paras; Moralès, Daniel; Natarajan, Karthik; Nyberg, Fredrik; Ostropolets, Anna; Park, Rae Woong; Park, Jimyung; Posada, Jose; Prats‐Uribe, Albert; Rao, Gowtham; Reich, Christian; Rho, Yeunsook; Rijnbeek, Peter R.; Schilling, Lisa M.; Schuemie, Martijn J.; Shah, Nigam H.; Shoaibi, Azza; Song, Seok Young; Spotnitz, Matthew; Suchard, Marc A.; Swerdel, Joel N.; Vizcaya, David; Volpe, Salvatore; Wen, Haini; Williams, Andrew E.; Yimer, Belay Birlie; Zhang, Lin; Zhuk, Oleg; Prieto-Alhambra, Daniel; Ryan, Patrick B.

doi:10.1101/2020.04.22.20074336

Cited by 40 publications

(43 citation statements)

References 16 publications

(25 reference statements)

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“… 3 , 21 The overall comorbidity scores tended to be lower in patients with COVID-19 than in patients with seasonal influenza, and the patients admitted with COVID-19 were more frequently male with fewer comorbidities, as previously observed. 3 Whereas diabetes and overweight seem to be particular risk factors for COVID-19 hospitalisation, 3 , 21 , 22 , 23 major comorbidities such as heart failure, chronic respiratory disease, and cirrhosis, albeit frequently associated with COVID-19, 3 , 21 , 22 , 23 were more often observed in the seasonal influenza group. The higher short-term impact of these three conditions when compared with diabetes and obesity 24 is another argument in favour of an intrinsic increased severity of COVID-19.…”

Section: Discussionsupporting

confidence: 74%

“…Few studies have directly compared the respective burdens of the COVID-19 and influenza epidemics. 3 , 4 , 5 A comprehensive assessment of the outcomes and mortality of the two diseases and risk factors for hospitalisation and mortality could be used to identify specific at-risk populations, to strengthen and focus specific preventive measures in these populations, and to help define the future needs of health-care facilities. The aim of the present study was to compare, using French nationwide data, the population hospitalised for COVID-19 and the population hospitalised for influenza during the 2018–19 season, and to assess the differences in terms of risk factors, clinical characteristics, and outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study

Piroth

Cottenet

Mariet

et al. 2021

The Lancet Respiratory Medicine

451

441

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Background To date, influenza epidemics have been considered suitable for use as a model for the COVID-19 epidemic, given that they are respiratory diseases with similar modes of transmission. However, data directly comparing the two diseases are scarce.Methods We did a nationwide retrospective cohort study using the French national administrative database (PMSI), which includes discharge summaries for all hospital admissions in France. All patients hospitalised for COVID-19 from March 1 to April 30, 2020, and all patients hospitalised for influenza between Dec 1, 2018, and Feb 28, 2019, were included. The diagnosis of COVID-19 (International Classification of Diseases [10th edition] codes U07.10, U07.11, U07.12, U07.14, or U07.15) or influenza (J09, J10, or J11) comprised primary, related, or associated diagnosis. Comparisons of risk factors, clinical characteristics, and outcomes between patients hospitalised for COVID-19 and influenza were done, with data also stratified by age group. Findings 89 530 patients with COVID-19 and 45 819 patients with influenza were hospitalised in France during the respective study periods. The median age of patients was 68 years (IQR 52-82) for COVID-19 and 71 years (34-84) for influenza. Patients with COVID-19 were more frequently obese or overweight, and more frequently had diabetes, hypertension, and dyslipidaemia than patients with influenza, whereas those with influenza more frequently had heart failure, chronic respiratory disease, cirrhosis, and deficiency anaemia. Patients admitted to hospital with COVID-19 more frequently developed acute respiratory failure, pulmonary embolism, septic shock, or haemorrhagic stroke than patients with influenza, but less frequently developed myocardial infarction or atrial fibrillation. In-hospital mortality was higher in patients with COVID-19 than in patients with influenza (15 104 [16•9%] of 89 530 vs 2640 [5•8%] of 45 819), with a relative risk of death of 2•9 (95% CI 2•8-3•0) and an age-standardised mortality ratio of 2•82. Of the patients hospitalised, the proportion of paediatric patients (<18 years) was smaller for COVID-19 than for influenza (1227 [1•4%] vs 8942 [19•5%]), but a larger proportion of patients younger than 5 years needed intensive care support for COVID-19 than for influenza (14 [2•3%] of 613 vs 65 [0•9%] of 6973). In adolescents (11-17 years), the in-hospital mortality was ten-times higher for COVID-19 than for influenza (five [1•1% of 458 vs one [0•1%] of 804), and patients with COVID-19 were more frequently obese or overweight.Interpretation The presentation of patients with COVID-19 and seasonal influenza requiring hospitalisation differs considerably. Severe acute respiratory syndrome coronavirus 2 is likely to have a higher potential for respiratory pathogenicity, leading to more respiratory complications and to higher mortality. In children, although the rate of hospitalisation for COVID-19 appears to be lower than for influenza, in-hospital mortality is higher; however, low patient numbers limit this finding...

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study

Piroth

Cottenet

Mariet

et al. 2021

The Lancet Respiratory Medicine

451

441

View full text Add to dashboard Cite

show abstract

“…Second, we selected a control group without acute respiratory failure. However, ARDS patients are usually older and have more comorbidities than COVID-19 patients [33]. Moreover, they are, by definition, mechanically ventilated.…”

Section: Discussionmentioning

confidence: 99%

The Acquisition of Multidrug-Resistant Bacteria in Patients Admitted to COVID-19 Intensive Care Units: A Monocentric Retrospective Case Control Study

et al. 2020

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Whether the risk of multidrug-resistant bacteria (MDRB) acquisition in the intensive care unit (ICU) is modified by the COVID-19 crisis is unknown. In this single center case control study, we measured the rate of MDRB acquisition in patients admitted in COVID-19 ICU and compared it with patients admitted in the same ICU for subarachnoid hemorrhage (controls) matched 1:1 on length of ICU stay and mechanical ventilation. All patients were systematically and repeatedly screened for MDRB carriage. We compared the rate of MDRB acquisition in COVID-19 patients and in control using a competing risk analysis. Of note, although we tried to match COVID-19 patients with septic shock patients, we were unable due to the longer stay of COVID-19 patients. Among 72 patients admitted to the COVID-19 ICUs, 33% acquired 31 MDRB during ICU stay. The incidence density of MDRB acquisition was 30/1000 patient days. Antimicrobial therapy and exposure time were associated with higher rate of MDRB acquisition. Among the 72 SAH patients, 21% acquired MDRB, with an incidence density was 18/1000 patient days. The septic patients had more comorbidities and a greater number of previous hospitalizations than the COVID-19 patients. The incidence density of MDRB acquisition was 30/1000 patient days. The association between COVID-19 and MDRB acquisition (compared to control) risk did not reach statistical significance in the multivariable competing risk analysis (sHR 1.71 (CI 95% 0.93–3.21)). Thus, we conclude that, despite strong physical isolation, acquisition rate of MDRB in ICU patients was at least similar during the COVID-19 first wave compared to previous period.

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“…This project has received support from the European Health Data and Evidence Network Edward Burn 1,2,51 , Seng Chan You 3,51 , Anthony G. Sena 4,5 , Kristin Kostka 6 , Hamed Abedtash 7 , Maria Tereza F. Abrahão 8 , Amanda Alberga 9 , Heba Alghoul 10 , Osaid Alser 11 , Thamir M. Alshammari 12 , Maria Aragon 1 , Carlos Areia 13 , Juan M. Banda 14 , Jaehyeong Cho 3 , Aedin C. Culhane 15 , Alexander Davydov 16,17 , Frank J. DeFalco 4 , Talita Duarte-Salles 1 , Scott DuVall 18,19 , Thomas Falconer 20 , Sergio Fernandez-Bertolin 1 , Weihua Gao 21 , Asieh Golozar 22,23 , Jill Hardin 4 , George Hripcsak 20,24 , Vojtech Huser 25 , Hokyun Jeon 26 , Yonghua Jing 21 , Chi Young Jung 27 , Benjamin Skov Kaas-Hansen 28,29 , Denys Kaduk 16,30 , Seamus Kent 31 , Yeesuk Kim 32 , Spyros Kolovos 33 , Jennifer C. E. Lane 33 , Hyejin Lee 34 , Kristine E. Lynch 18,19…”

Section: Acknowledgementsmentioning

confidence: 99%

Deep phenotyping of 34,128 adult patients hospitalised with COVID-19 in an international network study

et al. 2020

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Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.

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Deep phenotyping of 34,128 patients hospitalised with COVID-19 and a comparison with 81,596 influenza patients in America, Europe and Asia: an international network study

Abstract: Background

Cited by 40 publications

References 16 publications

Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study

Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study

The Acquisition of Multidrug-Resistant Bacteria in Patients Admitted to COVID-19 Intensive Care Units: A Monocentric Retrospective Case Control Study

Deep phenotyping of 34,128 adult patients hospitalised with COVID-19 in an international network study

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